Nailbed laceration

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Background

  • Results from a crush injury or blunt trauma

Clinical Features

  • May include one or more of the following:
    • Nail avulsion (partial or complete)
    • Nailbed laceration
    • Distal phalanx fracture

Differential Diagnosis

Workup

  • Obtain xrays of the involved digits if there is suspicion for fracture

Management

  • Repair simple lacerations using 5-0 or 6-0 absorbable sutures
  • Trephination should be performed to allow drainage of blood after the nail is reinserted into the nail fold
  • The nail may be sutured in place through the trephinated hole(s) or taped in place
  • A nail-shaped adaptic or non-adherent gauze may be placed under the nail fold if the original nail is misplaced or unusable

Prognosis

  • Complete nail growth may take 70 to 160 days
  • Potential risk of nail deformity and losing the nail

See Also